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    Effects of ursodeoxycholic acid, glutamine and polyclonal immunoglobulins on bacterial translocation in common bile duct ligated rats
    (Blackwell Publishing Asia, 2003) Aldemir, M; Geyik, MF; Kökoglu, ÖF; Büyükbayram, H; Hosoglu, S; Yagmur, Y
    Background: The present study was conducted to investigate the effects of ursodeoxycholic acid (UDCA), glutamine and i.v. polyclonal immunoglobulins ( IVIG) on the bacterial translocation (BT) and intestinal integrity of obstructive jaundice (OJ) in an animal model. Methods: Fifty rats were randomized into five groups containing 10 rats each. All procedures were performed aseptically under general anaesthesia using intramuscular ketamine ( 25 mg/kg). The abdomen was opened and the common bile duct was identified, mobilized, doubly ligated using 5-0 silk and divided. In group 1 ( the 'sham' group), the rats had a similar incision followed by mobilization of the common bile duct (CBD), without ligation or division. In group 2 rats, only common bile duct ligation (CBDL) was performed. In group 3, CBDL was performed and UDCA was administered by orogastric intubation once daily. In group 4 rats, CBDL was performed and glutamine was given by orogastric intubation once daily. Therapeutic substances were started orally on the day CBDL was fulfilled and were continued for 7 days. In group 5, IVIG was administrated via a femoral vein catheter just before CBDL. The animals were killed at the end of the 7th day, and serum levels of total bilirubin ( TB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and gamma-glutamyl transpeptidase (GGT) were measured. Mesenteric lymph nodes (MLN), liver, spleen and blood were cultured. The terminal ileum specimens were examined histopathologically. Results: Bacterial translocation significantly increased in the MLN and spleen of rats in group 2 as compared to groups 3, 4 and 5 (P < 0.05, P = 0.001, P = 0.001, respectively). The BT of the liver in group 2 was significantly higher than that of group 5 (P < 0.05). In the blood, the BT was significantly higher in group 2 than groups 3, 4 and 5 ( P < 0.05). The bacterial counts, colony- forming units per gram tissue (cfu/g), were found significantly higher in MLN, liver and spleen of rats in group 2 than those of groups 3, 4 and 5 ( P = 0.000). The average villus height in the group 4 was significantly higher than that of groups 2, 3 and 5 ( P = 0.000). Conclusion: The present experimental study has demonstrated that the administration of glutamine, UDCA and IVIG reduce the incidence of BT and additionally glutamine preserves intestinal mucosal integrity.
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    Öğe
    Epidemiology and control of nosocomial infections in paediatric surgery
    (W B Saunders Co Ltd, 2002) Önen, A; Cigdem, MK; Geyik, MF; Kökoglu, ÖF; Otçu, S; Öztürk, H; Dokucu, AI
    The purpose of this study was to determine the epidemiology and control of hospital-acquired infections (HAI) in paediatric surgery. We reviewed 2844 hospitalized children in a paediatric surgical clinic between January 1997 and December 2000. The diagnosis of HAI was made based on criteria proposed by Centers for Disease Control and Prevention (CDC). The incidence, type of micro-organisms and infections, age, sex, risk factors, and the economic aspects were recorded. The mortality, duration of hospitalization and economic aspects of patients were compared with 78 control patients matured for age, sex and primary illness and free of HAI. There were 78 children with HAI, the overall incidence was 2.74% (4.99% in 1997, 3.89% in 1998, 1.33% in 1999, 1.44% in 2000). The most frequent infections were surgical wound (28 patients) and urinary tract (25 patients). The most frequent risk factors were urethral catheterization (10.26%), trauma (9.25%), and parenteral nutrition (8.70%). Mean hospitalization was 16 days (range 4-28 days) in patients with infection compared with nine days (range 2-22 days) in control group. Eight patients died in the infection group, while two died in the control group. HAI caused a significant increase in mortality, prolonged hospitalization and increased costs (P < 0.05, P < 0.001, P < 0.001, respectively).